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Canada 'Dad should have been in personal care': Elderly patient was transferred 5 times in 4 months before his death

14:40  12 december  2019
14:40  12 december  2019 Source:   cbc.ca

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The family of 86-year-old Alan Abbott says he wanted to live out his days in a personal care home in Winnipeg. But he never got admitted to one.

Instead, his daughter says he died in pain after being shuffled between four hospitals and a health care centre — in a period of just under four months — before his death on Nov. 26.

"I have no words. It was debilitating. It was humiliating," said Abbott's 53-year-old daughter, Donna Dagg, her voice breaking. "Nobody should have to go through that in their final months and days. They should not have to be in that kind of pain."

Abbott had multiple sclerosis and heart issues. He lived in a Transcona condo with his wife, Doris, who was also elderly and was awaiting hip surgery.

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Dagg says earlier this year, Abbott started finding it harder to cope at home. His legs were swelling and he was falling a lot. He was in and out of hospital every couple of weeks or so.

After yet another fall in early July, his daughter took him to his family doctor.

"The family doctor looked at all of his history and said to my dad, 'Do you feel that you're OK managing at home?' And Dad said no, he wanted to go to a personal care home. He thought that it was time," Dagg said.

The doctor admitted him to Concordia Hospital, Dagg says, and asked that they panel him for long-term care.

a man wearing a hat and glasses: The family of Winnipeg man Alan Abbott, seen here in a 2015 photo, says he died while they were trying to arrange to have him placed in a personal care home. He was transferred five times between health care facilities in just under four months before his death in November.© Provided by cbc.ca The family of Winnipeg man Alan Abbott, seen here in a 2015 photo, says he died while they were trying to arrange to have him placed in a personal care home. He was transferred five times between health care facilities in just under four months before his death in November.

Under the Winnipeg Regional Health Authority's panelling process, a board reviews applications for placement in a personal care home. If the application is approved, the person is placed on a wait list for their choices of personal care homes, and applications are forwarded to the homes.

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After he had spent a couple of weeks at Concordia, Dagg requested a meeting to find out what progress was being made on getting her father into a personal care home.

On July 29, the family met with health professionals. A social worker walked them through the personal care home panelling process. They were told to pick their top three choices of homes.

Dagg says everything seemed to be going in the right direction, until the home care representative weighed in.

"They kept talking about 'priority at home' program, whereby they could put in more home care support.… They kept saying over and over their only goal was to get him back home."

But Abbott's family was unimpressed with that idea. He'd had home care for several years and the family found it plagued with problems, including workers not showing up for shifts.

Dagg sensed people in the Concordia meeting were rallying around the home care plan, and says that she, her mom and her sister felt ignored.

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Back to Square 1

Then, on Aug. 9, Concordia transferred Abbott to St. Boniface Hospital.

The family was told that  St. Boniface could "much better care for his needs," Dagg says, but she wasn't sure what that meant. They appeared to be doing the same things as Concordia, she says — just trying to get him up and walking.

On Aug. 18, St. Boniface transferred him to Seven Oaks Hospital.

He was transferred yet again on Sept. 4, this time to the transitional care unit at the Misericordia Health Centre.

Again, they were told that the Misericordia unit could best meet Abbott's needs.

"We didn't even know at that point what his needs really were, because we weren't getting any information from anybody," Dagg said.

a group of people posing for the camera: Alan Abbott in a 2017 photo with, left to right, his great-granddaughter Emily Kay, his daughter, Donna Dagg, and his granddaughter Amanda Dagg.           © Provided by cbc.ca Alan Abbott in a 2017 photo with, left to right, his great-granddaughter Emily Kay, his daughter, Donna Dagg, and his granddaughter Amanda Dagg.

Her father was extremely unhappy at Misericordia, she says.

At her request, the family met with the long-term care access navigator at Misericordia on Oct. 16. "[He] said, 'Yep, we agree. Your dad should be panelled [for personal home care]. Where would you like him to go?'"

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To Dagg, it felt like starting from Square 1.

They reiterated the preference they'd expressed in July, but said they would accept another placement to get him into a care home.

"[The Misericordia navigator] said, 'OK … once my signature is on the paper then it's going to happen very quickly, within a week,'" Dagg said.

When two more weeks passed with no action, she followed up. On Nov. 4,  she was assured her father would be approved that week.

But Abbott never got his placement. Two days later, he fell at Misericordia.

He was taken to Grace Hospital emergency, where doctors informed Dagg nothing could be done, because Abbott's heart and kidneys were failing. Treating one would knock out the other, she was told.

"So they shipped him back to Misericordia," where his health quickly declined, she said.

"He stopped eating. He didn't want to be there," she said. "'I just want to go home,'" she remembers him wailing.

"He couldn't tell us where he was hurting but he was continually crying. He was defeated at that point."

She says her witty, stoic dad — who, despite battling MS for more than 40 years, was always upbeat and willing to help anyone — "had given up."

On Nov. 25, the night before he died, a nurse met her at the elevator with the news that her father wasn't doing well. What she saw that night still haunts her.

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"He was laying in his bed facing the wall and he was thrashing — like, literally thrashing," Dagg said. "[He] threw his legs off towards the wall and his hands were clenched around the bed rail, and he was just screaming and screaming and screaming."

As she and staff tried to settle him down, she says, "the nurse said to me, 'Donna, you shouldn't be in here.… We haven't seen anything like this before. We're trying to get ahold of somebody from palliative care. We don't know what to do.'

"And I'm, like, 'What do you mean you don't know what to do?'"

Dagg said the nurse finally got a prescription for a shot, and he eventually calmed down. She later spoke to the night nurse who told her he was resting comfortably.

By morning, he was dead.

Story should 'raise alarm bells': advocate

She says the whole experience has left her family reeling.

A Winnipeg Regional Health Authority spokesperson said the authority can't comment on personal health information, but expressed condolences and invited Dagg to call patient relations, which she did this week. Dagg also intends to get medical charts from all five institutions.

Abbott's story is disturbing, says one health-care advocate.

"I think the whole story should rattle any Manitobans who read it, because it's really signalling an issue within our health care system as it relates to seniors care," said Brianne Goertzen.

Sukh Ram et al. posing for the camera: Abbott is seen with his granddaughter, Amanda Dagg, in a 2016 family photo. Donna Dagg says her father was witty and stoic, but after multiple transfers between health-care facilities, he 'had given up.'© Provided by cbc.ca Abbott is seen with his granddaughter, Amanda Dagg, in a 2016 family photo. Donna Dagg says her father was witty and stoic, but after multiple transfers between health-care facilities, he 'had given up.'

She's the provincial director of the Manitoba Health Coalition, a non-profit health-care advocacy association.

"The fact that he was transferred a number of times — the fact that he wasn't respected in his wishes, or his family doctor's wishes, or his family wishes — should also raise alarm bells in Manitobans," Goertzen said.

"And it really speaks to the fact that we're not dignifying our seniors within this province by ensuring that they're aging in a place and receiving the care that they need, when they need it."

Dagg wrote an obituary for her father which has been circulating on social media. It spoke about his life and his passions, but also called out the provincial health-care system.

"On November 26, 2019, as a result of our broken health care system, dad's suffering ended," it started.

"Dad spent the last 4 months shuffled between 5 hospitals and was placed into transitional care, waiting for WRHA to sign the paperwork for a personal care home admission that sadly never came."

She says she feels she owes it to her father to draw attention to his suffering.

"Dad should have been in personal care in the summertime," she said.

"He would have been far happier, his spirit would have been much … brighter. He would have had something to look forward to.

"This travelling between hospitals was just awful."

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